Bursary Fund Application Form

Telephone: 031 207 7099 email: info@jamiat.org.za

Fax: 031 207 4163 Physical address: 223 Alpine Road, Durban, 4091

N. B. This application form must reach the offices of the Jamiatul-Ulama and signed by us

before 17h00, 31 January of the year for which you are applying. Should the 31th fall on a

weekend, the due date will be the first Monday following the 31th. No extension will be

allowed. To those who are successful, funds will be forwarded to the institutions by the end

of February.

For office use only

Date submitted: For academic year:

Reference number: Date of interview:

-1-

For fields which require a choice, tick off the one that applies.

P E R S O N A L I N F O R M A T I O N

Surname:

First name/s:

Gender: M F Age:

ID number:

Phone numbers: (Home) (Work)

(Cellular) (Fax)

email:

Physical address:

Marital status:

No. of dependents:

South African citizen? Y N

If not, state country of origin:

Occupation:

Gross Monthly Income:

Contact person

Telephone Relationship

Have you applied to any other institution for financial assistance?

(a) in the past? Y N

If yes, fill in the details in the table

Institution Year Amount requested Amount received

(b) for the current/next academic year? Y N

If yes, fill in the details in the table

Institution Year Amount requested Amount promised

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(c) from the Jamiatul-Ulama? Y N

If yes, fill in the details in the table for the past three years

Year Amount requested Amount received

A C A D E M I C R E C O R D

1. Year of matriculation

2. Last school attended:

Area/Province of school

(Please attach a copy of your matric certificate, irrespective of year of tertiary year

of study. If you are a scholar, attach your last year-end report)

3. Tertiary study:

Intended course of study

Institution

Duration of course years

Year of study year (1st, 2nd, etc)

N.B. If this is not your first year of study, a statement of results for the previous

years must accompany this application.

Amount of financial assistance required: (N.B. Per annum amounts only)

Purpose Amount

Course fees R

Text books R

Travelling R

Accommodation R

Other (please specify) R

Total R

TOTAL REQUIRED AFTER OTHER SPONSORSHIP R

Have you completed any other tertiary education? Y N

If yes, state degree/diploma:

Year of completion:

-3-

Institution:

N. B. An official letter from the educational institution showing all costs for the

next year must accompany this application.

M O T I V A T I O N

1. Write a separate attached letter (preferably using a word-processor) to substantiate

your application. In this letter you must explain your financial situation fully. The

following issues must be addressed:

• the number of people in the household

• the number of children and your position in the household (e.g. 2nd child of

five children)

• the financial status of your parents/guardians (if unmarried)

• how you are coping with meeting your basic needs

• how many of the members of the household are earning

• how you supplement your finances if necessary e.g. by way of part-time jobs

• if you are a part-time student, to what extent can you meet your financial

obligations in respect of your study costs?

2. Certified copies of

• ID document/birth certificate/immigration documents

• Certified copy of matric certificate

• Previous results from other tertiary institutions (if applicable)

• Letter of acceptance from institution where acceptance is being sought

• Official letter detailing costs

• Testimonial from local Imam

• Two other character testimonials

D E C L A R A T I O N

I, _________________________ hereby declare that all information supplied by me in this

application is true and correct. I am aware that the abuse of public funds will constitute

fraud. I have also declared to the Jamiatul-Ulama all assistance that I have received in the

past and those that I have been promised help from other institutions for this academic year.

______________________ ______________________ ______________________

NAME SIGNATURE DATE

Jamiatul Ulama KZN

Declaration of Finances

I,

ID Number:

Of (Address):

hereby declare that all the information supplied herein and in supplementary documents and letters is true

and correct.

I also declare that due to my present financial situation, I may be eligible and deserving of assistance from

the Zakaah Funds of Jamiatul Ulama (KZN), and I accept that any aid rendered to me in the form of cash or

kind will be at the sole discretion of the Jamiat Bursary Committee.

I further duly authorize the Bursary Committee of Jamiatul Ulama (KZN) or any of its representatives to

receive Zakaat Funds on my behalf and disburse the same to my creditors in payment of any of my current

debts or whatever debts I may incur due to my aforesaid financial situation.

I declare that if I receive assistance from any other source or person, I will disclose such information to the

Jamiat Bursary Committee of the Jamiatul Ulama (KZN).

Kindly provide the information below to confirm Zakaat eligibility for a bursary:

Applicants will be required to provide the following documents to confirm their financial position:

3 months Salary slips (if applicable)

3 months Bank Statements (if applicable)

Proof of Grant (if applicable)

_______________________ _______________________ _______________________ NAME SIGNATURE DATE

Students Statement of Finances

Monthly Income (salary/state grants/investments) (If any)

Total Savings (Cash/Bank) (If any)

Total Value of Jewellery (Gold/Silver) (If any)

Total value of debts (If any)

R____________________

R____________________

R____________________

R____________________

Jamiatul Ulama KZN – Bursary Requirements Tel: 031 207 7099 Fax: 031 207 4163 email: finance@jamiat.org.za

Applicant Name:

Applicant ID no.:

Kindly take note of the following criteria prior to application:

1. The Jamiatul Ulama KZN bursary fund is a ZAKAAT fund, therefore only applicants

eligible for ZAKAAT will be considered.

2. The fund is only open to those residing in the KwaZulu-Natal region.

3. Applicants must have a valid South African identity document.

4. Application is open for all courses (secular/Islamic),

5. Only Females studying through distance learning will be considered.

If you do not meet any one of the conditions above we humbly request that you do not

apply as the application will not be considered.

Bursary Application Checklist

No. Requirements Check

1. Letter of Motivation

2. Certified Copy of your I.D. Document

3. If Matriculant, Trial Exam Results and Final Results, with

Testimonial as soon as they are Released

4. If at University/ Darul Uloom, Annual examination results

5. Letter of Acceptance from the institution

6. Full details of the course

7. Full details of the cost for the course

8. Testimonial from your local Imam

9. 2 Testimonials from other than your family members

10. 3 Months Bank statement or an affidavit declaring the nonexistence of the same.

PLEASE ENSURE THAT YOU SUBMIT THIS CHECKLIST WITH YOUR APPLICATION